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先天性支气管闭锁患儿使用喉罩气道的麻醉管理

Anesthetic Management Using a Laryngeal Mask Airway in a Child With Congenital Bronchial Atresia.

作者信息

Gomi Yuki, Taguchi Asuka, Matsunari Sahoko, Iwamoto Taisuke, Kawamoto Yui, Tachikawa Satoshi, Masuda Rikuo, Gotoh Kinuko, Iijima Takehiko

机构信息

Department of Perioperative Medicine, Division of Anesthesiology, Showa University School of Dentistry, Tokyo, Japan.

Department of Anesthesiology, Showa University Fujigaoka Hospital, Yokohama, Japan.

出版信息

Anesth Prog. 2017 Summer;64(2):102-103. doi: 10.2344/anpr-64-02-01.

Abstract

Congenital bronchial atresia is a relatively rare malformation that causes a segmental obstruction of the bronchus during the fetal period. The peripheral lung distal from the obstructed bronchus becomes hyperinflated because of the unidirectional flow through collateral check-valve entry. Positive pressure ventilation during general anesthesia may cause a rupture of the bulla, resulting in pneumothorax. An 8-year-old girl, who had to undergo oral surgery, was diagnosed as having congenital bronchial atresia and one-fifth of her lung was poorly ventilated. We planned to perform general anesthesia under spontaneous respiration using a laryngeal mask, which was well tolerated.

摘要

先天性支气管闭锁是一种相对罕见的畸形,在胎儿期导致支气管节段性梗阻。由于通过侧支单向活瓣进入的单向气流,梗阻支气管远端的外周肺出现过度充气。全身麻醉期间的正压通气可能导致肺大泡破裂,从而引起气胸。一名必须接受口腔手术的8岁女孩被诊断患有先天性支气管闭锁,其五分之一的肺通气不良。我们计划使用喉罩在自主呼吸下实施全身麻醉,患儿对此耐受性良好。

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